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Early Signs
Explore explanations, everyday questions and next steps connected with early signs.
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Signs & concerns
What to observe about a child learning task responsibility on a home visit
On a home visit, a frontline worker should observe how a child takes on, follows through and completes simple age-appropriate tasks — fetching items, tidying toys, basic self-care — noting willingness to start, how much help is needed, and whether they finish. These are everyday observations to note and encourage, not diagnose. A clear, persisting gap from same-age peers or no progress over months should be flagged gently and routed for a general developmental check.
Read the answer AnswerObserving Task Speed During a Home Visit
On a home visit, a frontline worker should observe how a child manages single everyday tasks — starting willingly, keeping going, and finishing at an age-typical pace. This is gentle observation to note and monitor, not to diagnose. Pace varies widely, so what matters is a clear, repeated pattern across several tasks and more than one visit, not one slow moment. Persistent difficulty finishing across tasks should be routed to the PHC for a developmental check.
Read the answer AnswerObserving Temporal Concepts During a Home Visit
During a home visit, a frontline worker should observe how a child understands everyday time words and sequences — "now", "later", "before", "after", parts of the day — and whether daily routines carry meaning. Temporal concepts grow with language and play, so the aim is to observe and note patterns, not test or diagnose. A persistent, wide gap, especially alongside communication delays, signals the need for a general developmental check.
Read the answer AnswerObserving Tiptoe Balance on a Home Visit
On a home visit, a frontline worker should observe — not test — a child learning tiptoe balance: whether they can rise onto their toes, hold steady briefly, use both legs evenly, and come down without falling. This gross-motor skill (ICF d4) develops gradually from around 2.5–3 years, so steady progress matters more than one attempt. Persistent asymmetry, constant toe-walking, very stiff or floppy tone, or balance well behind peers are reasons to encourage a gentle developmental check. Nothing observed at home is a diagnosis.
Read the answer AnswerObserving tiptoe walking during a home visit
On a home visit, observe whether the child can put heels flat when standing and walking, whether tiptoe walking is occasional or constant, and whether calves feel stiff or tight. Occasional toe-walking is common and usually harmless in early walkers under 2–3. Flag for a developmental check if it is constant past age 3, only on one side, calves resist flattening, or other milestones are delayed. This is a watch-and-note observation, never a home diagnosis.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning toileting skills?
On a home visit, a frontline worker should observe a child's toileting readiness: staying dry for longer periods, awareness of needing to go, communicating the need, sitting on a potty, managing clothing with help, and washing hands with prompting. These are signs to observe and note, not to diagnose. Control usually develops between 18 months and 4 years. Persistent delay past 3.5-4 years, regression, pain or delays across several areas warrant referral to the PHC or developmental team.
Read the answer AnswerWhat to observe about a child's transitioning during a home visit
During a home visit, a frontline worker should observe how a child moves between positions (lying to sitting, sitting to standing), shifts between activities and attention, and copes with social changes like a new person or routine. Smooth transitions for the child's age are reassuring; persistent stiffness, floppiness, or extreme distress with change across many settings are signs to note and share with a medical officer. This is observation to monitor, not a home diagnosis.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about turn-taking skills?
During a home visit, a frontline worker should observe whether the child shows back-and-forth interaction — responding to smiles, joining peek-a-boo or ball games, waiting briefly for a turn, and sharing attention between a toy and the caregiver. These are everyday signs to note and encourage, not to diagnose. Caregiver interaction strongly supports turn-taking. If back-and-forth is persistently absent for the child's age across visits, gently route the family to a general developmental check.
Read the answer AnswerObserving understanding on a home visit
On a home visit, observe how a child understands everyday words, names and simple requests in their home language — turning to their name, looking at named objects, following a simple instruction, and responding to gesture and tone. Understanding grows ahead of speech, so watch comprehension rather than talking. These are things to observe and note, not diagnose at home; a persisting gap, judged in the home language, is a reason to check hearing first and route the family for a developmental screen.
Read the answer AnswerObserving Verbal Communication on a Home Visit
On a home visit, a frontline worker should observe how a child uses voice and words to connect: babbling, pointing, naming, following simple instructions, responding to their name, and taking turns in 'chat'. Match what is seen to age-appropriate milestones and note gaps. These are signs to observe and monitor across visits, not to diagnose at home. A hearing check comes first, and a persisting gap is the cue to route the family for a friendly developmental screen.
Read the answer AnswerVerbal knowledge: what a frontline worker should observe on a home visit
During a home visit, a frontline worker should observe how a child understands and uses language — responding to their name, following simple requests, naming familiar people and objects, and using words to ask, point and share. These are everyday observations to note and discuss, never to diagnose at home. A persistent gap, very few words for age, or little response to speech (with a hearing check first) is reason for a developmental check and prompt, gentle support.
Read the answer AnswerObserving verbal reasoning on a home visit
During a home visit, a frontline worker should observe how a child reasons with language: following one- or two-step instructions, answering simple "why" and "how" questions, comparing or sorting things, explaining wants, and making small guesses in play. This is observing and noting in the child's home language — not testing or diagnosing. If the child persistently struggles to understand or reason with words for their age, and especially across several visits, route the family for a developmental check after ruling out hearing first.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning verbal understanding?
On a home visit, a frontline worker should observe how a child understands language — turning to their name, following simple words and gestures in the home language, pointing to named people or objects, and responding to everyday instructions. These are observations to note and track, not to diagnose. Always confirm a hearing screen first, and route any child whose understanding seems clearly behind age to a routine developmental check.
Read the answer AnswerObserving vestibular processing during a home visit
On a home visit, observe how a child responds to movement and body position — swinging, spinning, climbing, being lifted, steps and uneven ground. Watch for strong movement-avoidance (fear, clinging, easy dizziness or car-sickness) or constant movement-craving (endless spinning, jumping, never dizzy), plus balance and posture for age. These are observations to note and share, not to diagnose at home; refer for a developmental and hearing check when the pattern is strong, frequent and disrupts daily play or walking.
Read the answer AnswerObserving Visual Motor Integration on a Home Visit
On a home visit, a frontline worker should observe how a child coordinates eyes and hands — reaching accurately, grasping with a finger-thumb pinch, stacking, posting shapes, scribbling and copying for their age. These are observations to monitor and route, not diagnose at home. A persistent gap across several visits, clumsiness affecting daily tasks, or avoiding hand-eye play warrants a gentle developmental check after confirming vision and hearing seem fine.
Read the answer AnswerWhat to observe about a child's visual processing on a home visit
On a home visit, observe how a child uses vision in everyday play: looking at faces, following a moving toy, reaching accurately for objects, and noticing things across the room. Visual processing is how the brain makes sense of what the eyes see. These are signs to note and monitor, not to diagnose at home — and any concern should go first to a vision and hearing check at the primary health centre.
Read the answer AnswerVisual reception: what to observe on a home visit
On a home visit, observe how a child uses their eyes to take in their world: following a face or toy, looking towards movement, reaching for what they see, and recognising familiar faces, objects and pictures as they grow. These are signs to note and monitor, not to diagnose. If a child consistently does not look, track or respond for their age — across weeks or several areas — flag it for a developmental check, starting with a hearing and vision screen.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about visual recognition?
On a home visit, a frontline worker observes how a child uses their eyes to notice, follow and recognise people and objects — eye contact, smiling at familiar faces, following a moving toy, looking for a dropped object, and reaching for known things. These are observations to note and monitor, not to diagnose. Persistent absence of looking, following or recognising familiar faces for the child's age, or eyes that don't move together, signals a vision and developmental check — vision first, since many causes are treatable.
Read the answer AnswerVisual scanning: what to observe on a home visit
On a home visit, a frontline worker should observe how the child uses their eyes to find and follow things — turning towards faces and moving objects, shifting gaze between toys, tracking a slowly moving object, and searching for dropped or hidden items. Signs worth noting include consistently missing one side, not fixing or following by the expected age, squinting or head-tilting, and little interest in faces. These are patterns to observe and route, not to diagnose; a vision and hearing check comes first.
Read the answer AnswerVisual Spatial Processing on a Home Visit
On a home visit, observe how the child uses eyes and hands together to understand space: accurate looking and reaching, judging distances while moving, stacking and nesting objects, posting shapes, and finding hidden toys. These are everyday signs of growing visual spatial processing. Note patterns rather than diagnose, check for vision concerns first, and route persisting or multi-area difficulties to a general developmental check.
Read the answer AnswerObserving visuospatial skills on a home visit
On a home visit, observe how the child uses eyes and hands together to understand space, shape and position — fitting objects into containers, stacking, simple puzzles, copying shapes, and moving around the home without bumping. These are skills to watch and note over several visits, not to diagnose. Check vision and hearing first, and if a gap persists across visits or affects more than one area, route the family gently to a developmental check.
Read the answer AnswerObserving vocabulary on a home visit
On a home visit, a frontline worker should observe how a child understands and uses words for their age — responding to their name, following simple instructions, pointing and gesturing, saying clear words, and imitating sounds in play. These are things to note across visits, not to diagnose at home. Check that hearing has been screened, and gently route any concern to a PHC or developmental check.
Read the answer AnswerObserving vocabulary comprehension and expression on a home visit
On a home visit, a frontline worker should observe how a child understands words (responds to their name, follows simple instructions, points to named objects) and expresses them (babbling, first words, joining words, using gestures) — counting language across all home languages. These are observations to note and discuss, not diagnose. A gap that persists across months, very little understanding for age, or loss of words is a reason to route the family kindly for a developmental check.
Read the answer AnswerObserving vocabulary knowledge on a home visit
On a home visit, a frontline worker should observe how a child understands and uses words in everyday play — recognising familiar names and objects, naming people and things, joining words by age 2, and picking up new words steadily over time. Note the home language too, and watch for steady growth and words used to connect. These are observations to note and route, not to diagnose; a hearing check comes first if words are slow.
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